Display Settings:

Format

Send to:

Choose Destination
J Palliat Med. 2013 Oct;16(10):1249-54. doi: 10.1089/jpm.2013.0164. Epub 2013 Sep 20.

Predictors of intensive end-of-life and hospice care in Latino and white advanced cancer patients.

Author information

  • 11 Group Health Research Institute , Group Health Co-operative, Seattle, Washington.

Abstract

BACKGROUND:

The role of end-of-life (EOL) care preferences and conversations in receipt of care near death for Latinos is unclear.

OBJECTIVE:

This study examines rates and predictors of intensive EOL and hospice care among Latino and white advanced cancer patients.

DESIGN:

Two-hundred-and-ninety-two self-reported Latino (n=58) and white (n=234) Stage IV cancer patients participated in a U.S. multisite, prospective, cohort study from September 2002 to August 2008. The Latino and white, non-Hispanic participants were interviewed and followed until death, a median of 118.5 days from baseline.

MEASUREMENTS:

Patient-reported, baseline predictors of EOL care included EOL care preference; terminal illness acknowledgement; EOL discussion; completion of a DNR order; and religious coping. Caregiver postmortem interviews provided information regarding EOL care received. Intensive EOL care was defined as resuscitation and/or ventilation followed by death in an intensive care unit. Hospice was either in- or outpatient.

RESULTS:

Latino and white patients received intensive EOL and hospice care at similar rates (5.2% and 3.4% for intensive care, p=0.88; 70.7% versus 73.4% for hospice, p=0.33). No white or Latino patient who reported a DNR order or EOL discussion at baseline received intensive EOL care. Religious coping and a preference for life-extending care predicted intensive EOL care for white patients (adjusted odds ratio [aOR] 6.69 [p=0.02] and aOR 6.63 [p=0.01], respectively), but not for Latinos. No predictors were associated with Latino hospice care.

CONCLUSIONS:

EOL discussions and DNR orders may prevent intensive EOL care among Latino cancer patients. Efforts should continue to engage Latino patients and caregivers in these activities.

PMID:
24053593
[PubMed - indexed for MEDLINE]
PMCID:
PMC3791053
[Available on 2014/10/1]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Mary Ann Liebert, Inc.
    Loading ...
    Write to the Help Desk